| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $988.00 | $2,898.00 | $3,444.00 | |
Kaiser Permanente
| Professional | $200.00 | $200.00 | $200.00 | |
United
| Facility | $2,446.00 | $2,446.00 | $2,446.00 | |
United
| Professional | $759.20 | $1,004.00 | $1,625.18 |